6th OCHER workshop on Clinical Communication Research January 11-13, 2017 The Oslo Communication in Healthcare Education and Research (OCHER) group The aims of OCHER workshops are two: 1) To provide a fruitful arena for discussion of research projects at all stages of development, with particular attention to challenges in methodology 2) To build a Scandinavian network (with international collaboration partners) of multidisciplinary researchers with interest in communication in health care Program Start: Wednesday 11 January, 10:00 End: Friday 13 January, 16:00 Venue: Thon Hotel Triaden, Lørenskog, Norway Address: Gamleveien 88 1476 Rasta Telephone: +47 66 10 97 00 Lecturers and group discussants: Professor J. Randall Curtis, University of Washington, Seattle, USA Keynote titles: - Measuring and improving communication about palliative care: What have we learned and where do we go from here? - Communication and decision-making with families of critically ill patients: Lessons from the successes and failures Professor Vikki Entwistle, University of Aberdeen, Scotland, UK Keynote titles: - Support for self-management among people with long-term conditions: re-formulating the concept to reflect and promote good practice - “How will we know if I’ve done a good job?” The challenges of evaluating person- centred care Local faculty: Pål Gulbrandsen, Arnstein Finset, and Jan Svennevig, University of Oslo, Hilde Eide, University College of Southeast Norway, Jennifer Gerwing, Akershus University Hospital Working languages: English, Scandinavian Page 1 of 36 Wednesday January 11 Time Activity Plenary room / Room A Room B 1000 Plenary Introduction, mutual presentation 1045 Break 1100 Plenary Vikki Entwistle Support for self-management keynote 1 among people with long-term conditions: re-formulating the concept to reflect and promote good practice 1230 Lunch 1315 Plenary J. Randall Curtis Communication and decision- keynote 2 making with families of critically ill patients: Lessons from the successes and failures 1415 Break 1430 Groups Session A1 Session B1 Roles, interactions, and discourse Narratives as patient aids Johansen Brembo Wallander Karlsen Birkemose 1530 Break 1545 Groups Session A2 Session B2 Personal awareness Virtual reality and tele- communication Fogtmann Amundsen Ørnes Steinsbekk 1645 End Groups 1715 Walk to Pål’s house for get- The walk is 20 minutes. Shoes should stand snow. Follow path on map! together 2000 Dinner at hotel Thursday January 12 0830 Groups Session A3 Session B3 Framework development Health literacy and information needs Ilstad Von Possel Callon Lie 0930 Break 0945 Groups Session A4 Session B4 New methods Conversation analysis Van Dulmen Svennevig Sundling Van der Laaken 1045 Break 1100 Plenary J. Randall Curtis Measuring and improving keynote 3 communication about palliative care: What have we learned and where do we go from here? 1200 Lunch Page 2 of 36 1245 Groups Session A5 Session B5 Forming collaborative groups Forming collaborative groups 1430 Break 1500 Groups Session A6 Session B6 Coding and measuring emotions Cross-cultural challenges Eide Berbyuk-Lindström Tranberg Leonhardt 1600 Plenary Vikki Entwistle “How will we know if I’ve done a keynote 4 good job?” The challenges of evaluating person-centred care 1630 Break 1645 Groups Session A7 Session B7 Unpleasant information Shared decision-making Løkkeberg 1 Hultberg Løkkeberg 2 Ammentorp 1745 End Groups 1900 Dinner at Feel free to entertain, make a short speech, or just enjoy food, drink, and hotel company Friday January 13 0830 Groups Session A8 Session B8 Interventions Nurses’ responses to emotions Nordfalk Hafskjold Mellblom Höglander 0930 Break/ Check-out 1000 Plenary Jette Ammentorp Healing health communication – workshop moving relationships 1115 Break 1130 Groups Session A9 Session B9 Experimental approaches Patient stigma, patient resources Holt Beach Haaland Krístjansdottir 1230 Lunch 1315 Plenary Jennifer Gerwing Project-oriented sequence keynote 5 analysis: A proposed meta-method for analyzing clinical practice 1400 Break 1415 Groups Session A10 Session B10 Work in collaborative groups Work in collaborative groups 1500 Plenary Evaluation and round-up 1530 End Page 3 of 36 Session A1 – Roles, interactions, and discourse Social workers’ discourse about children who experience domestic violence Ann-Kristin Johansen This article presents an analysis of social workers’ discourse about children who experience domestic violence. The data consist of interviews with 12 employees within family counseling and child welfare services in four different regions of Norway. The question asked is: How are dominant discourses reflected in informants’ descriptions of children who experience domestic violence and what are the consequences for social workers’ practice? The analysis shows that the informants encounter a variety of ethical and practical dilemmas in cases where children experience domestic violence. Significant differences were found between how social workers discursively expressed their ideals and how they acted in practice. When helpers spoke generally about children and violence they employed the discourse of the competent child and defined violence more broadly. However, when helpers moved from a position of looking in from the outside to that of experiencing a situation, they employed a discourse of physical and specific violence, and the traditional discourse about children as vulnerable was dominant. We discuss the available positions, possible dilemmas, paradoxes and challenges highlighted by social workers’ discursive practice. Page 4 of 36 Communication and interaction with conscious and alert critically ill patients during mechanical ventilation: Being a researcher in your own field Marte Marie Wallander Karlsen and Lena Heyn Aims The aim of the study is to obtain more in depth knowledge about interactions between healthcare personnel and patients who are conscious and alert on mechanical ventilation in Intensive Care Units (ICUs). It is a PhD-project and collaboration between Lovisenberg Diaconal University College, University of Oslo and Oslo University Hospital. Methods This is a qualitative study with a hermeneutic-phenomenological approach. 10 video recordings of natural occurring interaction in different contexts between health personnel and patients on mechanical ventilation constitute the data for this study. The videos are between 2- 4 hours in duration. In addition, interviews were conducted afterwards, both with healthcare personnel and with patients. One challenge when collecting data for this study was the fact that the researcher works at the same ICU as data were collected. Thus, a continuous reflection about role and the possible consequences for the data collected arose. The recruitment of patients was done with a sensitive approach, both towards the patients and healthcare personnel. Implications of not being reflective and aware of the potential pitfalls, pose a threat for both the credibility of the findings and the analytic process in general. So the choices made methodologically in preparation of the study and during the fieldwork have highly influenced the data collection period. Main issues that will be addressed in the presentation are 1) which type of distance or proximity one may adapt towards the participants 2) how to put on a research hat in a familiar clinical field and 3) ethical considerations when recruiting patients in critically illness without possibilities to consent verbally. This will be exemplified with narratives of concrete situations. The way it has been done could be useful to discuss and get feedback on. Page 5 of 36 Session B1 – Narratives as patient aids Informing didactics of patient decision aids for persons with osteoarthritis by knowledge on barriers according to Theory of Planned Behaviour (TPB) Brembo E., Lauritzen M., Lager A. R., Rumpsfeld M., van Dulmen, S., Eide H. & Kasper J. Background: Decision aids developed using the DAfactory approach are offered to patients and health professionals via the web-based platform ‘Mine Behandlingsvalg’, which in time will become an integrated part of the national health platform ‘helsenorge.no’. A component in the DA factory approach is developed to motivate users of the decision aids by subjecting potential barriers towards patient involvement. The method includes careful assessment of specific barriers of the patient group and video-based provision of patient stories telling about such barriers. At the best of our knowledge, such narratives have not been used or evaluated as components of decision aids in the way like in DAfactory. Complex interventions require stepwise evaluation and increasing evidence, including evaluation of single components. Patients with osteoarthritis (OA) make decisions when they are referred to an orthopedic outpatient evaluation. During consultations, the patient and surgeon need to make careful considerations about the risks and benefits of both surgical and non-surgical treatment alternatives. Objective: The study involves preliminary evaluation of a newly developed video-based component of a patient decision aid aiming to facilitate SDM. The study should increase knowledge about how reception of patient narratives on barriers towards SDM is processed by patients with osteoarthritis considering joint replacement. The study aim implies investigation of the patients’ internal reactions with focus on the potential to reduce motivational barriers to actively involve themselves in making their medical decisions.